| NPI | 1518740109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA MICHELE Manager 407-212-7113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TH0100X Psychologist, Health Service | |
| 207Q00000X Family Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |